Evidence map›Paper›PMID 38431299›Full record

Trial reportBMJ open2024

Effects of opioid-free anaesthesia compared with balanced general anaesthesia on nausea and vomiting after video-assisted thoracoscopic surgery: a single-centre randomised controlled trial.

Rui Bao, Wei-Shi Zhang, Yi-Feng Zha, Zhen-Zhen Zhao, Jie Huang, Jia-Lin Li, Tong Wang, Yu Guo, Jin-Jun Bian, Jia-Feng Wang

Open access · goldAbstract readRandomized Controlled Trial
In one paragraph

Trial report in BMJ open, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers, 3 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
9citing papers in PubMed, 3 pooled it
5.7field-weighted citation impact, top 4% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

9 citing papers in PubMed, 3 syntheses or guidelines pooled it, 10 citations in OpenAlex.

  1. Pooled it
  2. Pooled it
  3. Pooled it
  4. Trial
  5. Review
  6. Review
  7. Review
  8. Review
  9. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors at 1 institution in 1 country.

Rui BaoDepartment of Anesthesiology, Changhai Hospital, Naval Medical University, Shanghai, China.
Wei-Shi ZhangDepartment of Anesthesiology, Changhai Hospital, Naval Medical University, Shanghai, China.
Yi-Feng ZhaDepartment of Anesthesiology, Changhai Hospital, Naval Medical University, Shanghai, China.
Zhen-Zhen ZhaoDepartment of Anesthesiology, Changhai Hospital, Naval Medical University, Shanghai, China.
Jie HuangDepartment of Anesthesiology, Changhai Hospital, Naval Medical University, Shanghai, China.
Jia-Lin LiDepartment of Anesthesiology, Changhai Hospital, Naval Medical University, Shanghai, China.
Tong WangDepartment of Anesthesiology, Changhai Hospital, Naval Medical University, Shanghai, China.
Yu GuoDepartment of Anesthesiology, Changhai Hospital, Naval Medical University, Shanghai, China.
Jin-Jun BianDepartment of Anesthesiology, Changhai Hospital, Naval Medical University, Shanghai, China jfwang@smmu.edu.cn jinjunbicu@163.com.
Jia-Feng WangDepartment of Anesthesiology, Changhai Hospital, Naval Medical University, Shanghai, China jfwang@smmu.edu.cn jinjunbicu@163.com.ORCID 0000-0002-1753-6499
Second Military Medical University · CN

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectivesOpioid-free anaesthesia (OFA) has emerged as a promising approach for mitigating the adverse effects associated with opioids. The objective of this study was to evaluate the impact of OFA on postoperative nausea and vomiting (PONV) following video-assisted thoracic surgery.

designSingle-centre randomised controlled trial.

settingTertiary hospital in Shanghai, China.

participantsPatients undergoing video-assisted thoracic surgery were recruited from September 2021 to June 2022.

interventionPatients were randomly allocated to OFA or traditional general anaesthesia with a 1:1 allocation ratio. PRIMARY AND SECONDARY OUTCOME MEASURES: The primary outcome measure was the incidence of PONV within 48 hours post-surgery, and the secondary outcomes included PONV severity, postoperative pain, haemodynamic changes during anaesthesia, and length of stay (LOS) in the recovery ward and hospital.

resultsA total of 86 and 88 patients were included in the OFA and control groups, respectively. Two patients were excluded because of severe adverse events including extreme bradycardia and epilepsy-like convulsion. The incidence and severity of PONV did not significantly differ between the two groups (29 patients (33.0%) in the control group and 22 patients (25.6%) in the OFA group; relative risk 0.78, 95% CI 0.49 to 1.23; p=0.285). Notably, the OFA approach used was associated with an increase in heart rate (89±17 vs 77±15 beats/min, t-test: p<0.001; U test: p<0.001) and diastolic blood pressure (87±17 vs 80±13 mm Hg, t-test: p=0.003; U test: p=0.004) after trachea intubation. Conversely, the control group exhibited more median hypotensive events per patient (mean 0.5±0.8 vs 1.0±2.0, t-test: p=0.02; median 0 (0-4) vs 0 (0-15), U test: p=0.02) during surgery. Postoperative pain scores, and LOS in the recovery ward and hospital did not significantly differ between the two groups.

conclusionsOur study findings suggest that the implementation of OFA does not effectively reduce the incidence of PONV following thoracic surgery when compared with traditional total intravenous anaesthesia. The opioid-free strategy used in our study may be associated with severe adverse cardiovascular events. TRIAL REGISTRATION NUMBER: ChiCTR2100050738.

Indexed as

Analgesics, OpioidPostoperative Nausea and VomitingAnesthesia, GeneralChinaHumansPostoperative PainThoracic Surgery, Video-AssistedAnalgesics, OpioidAdult anaesthesiaANAESTHETICSThoracic surgery

Identifiers

PMID38431299
PMCPMC10910406
OpenAlexW4392344823

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.